Recently a nice lady presented concerned with a significant involuntary weight loss. She told me after the interview and exam that if the diagnosis turned out to be cancer that she didn't want to know about it. Ever. I've heard this very uncommon request before but no one ever really means it when it comes down to it. But I was reminded of a quote that is attributed to Mark Twain -- "Denial ain't just a river in Egypt."
This patient's encounter happened during the week following the Orlando massacre. And in the ensuing days there were various commentaries by pundits and public officials as to the explanation of the massacre that made the similarities of the lady's denial and the pundits' denials unavoidable. Denying a terminal illness is tantamount to denying in some way the final destiny for a person. The fear of death "haunts the human animal like nothing else; it is the mainspring of human activity -- activity designed largely to avoid the fatality of death." (Ernest Becker) Denial is typically a coping mechanism for people who need a little more time to process the shock of the news of having a serious medical problem. But denial is also the first stage some people experience when encountering the dying process. Denial comes in various degrees. Some deny the facts outright, totally, while others will accept the facts, but deny the seriousness of it. Then there are others who accept the facts and the seriousness of the diagnosis but project the blame on someone else or some other thing -- something the pundits and commentators are currently doing with respect to the Orlando massacre. In medicine, a denial of the facts can result in an inaccurate diagnosis and progressive misery or if delayed too long, even death. In the public arena, denials of the cause of a problem can likewise cause a progressive misery, and in the case of misdiagnosing the cause of recent mass killings, continued and certain death. There were various explanations for the cause of the Orlando massacre by various commentators. It was because of the guns, or a specific type of gun, or the lack of gun control purchases. (By the way, both the Muslim terrorist attacks at the Bataclan theatre in Paris, and in Orlando, happened in "gun-free zones") It was due to homophobia. Or it was the Christians for breeding "contempt" for the LGBTQIASM community. One Methodist cleric commented that this "kind of thinking promotes harm to our brothers and sisters". The gentle cleric apparently oblivious to the fact that some of the brothers think of themselves as sisters, and vice versa. It's naïve to think that an Islamic terrorist would be motivated by traditional Christian teachings on the morality of homosexual behavior and the sacredness of the marital bond between one man and one woman. Anyway, our Commander in Chief continues to deny that radical Islam is the dedicated enemy of our civil peace. He and others continue to deny the existential fact that the people most responsible for the recurrent mass killing of Americans and Europeans are Muslims. While it is true that not all Muslims are extremists, or terrorists, of the extremists and terrorists who are killing Americans and Europeans, they are Muslims. The mass killers are not Buddhists, Mormons, or Episcopalians. In medicine, if you have a scabies infestation, the remedy is not to eat less fat. If you have diabetes, the remedy is to lower the glucose, but not with medicine that lowers the blood pressure. It's difficult to believe that our government is not on top of trying to identify the collective lone wolves but in light of the facts that the Orlando killer had been interviewed by the FBI and had multiple encounters with law enforcement, and was not caught, is bothersome. Some say a politically correct environment foisted on the FBI by the administration is responsible for the miscue. Politically correct language induces people to unwittingly delay or miss identifying the offending agent. I remember the health department edicts in the early 80s, before the epidemiology of HIV was completely understood, that it was considered offensive and not proper to ask a patient if they were gay. Knowing so would accelerate results in arriving at a diagnosis. This was before the closet was flung wide open. There are many contradictions in the Islamic faith, a faith which encompasses demagogues, but also includes virtuous and worthy people. But it is indeed a faith that demands submission to such inherent contradictions that it allows a killer like Omar Mateen to engage in a false life, and feel right about it. And because of the psychological ambiguity of such a faith it also allows him to succumb to a form of violence that happens to be antithetical to Jesus Christ as the Way and the Truth and the Life. And herein lies for many the ultimate denial, especially for those who are suffering from too many diversions, or who are indifferent. And it is that of Christ. Diversions and indifference being a pseudo-remedy to the discomfort of truly knowing one's self. Such a denial is inconsequential if it were to turn out there is no God or Christ. But if it turns out for them that in the end they guessed wrong, or that their indifference mattered in the grand scheme of things, then for such a life the denial and its consequences will indeed have mattered. Eternally so. As for my nice lady patient, she turned out to have hyperthyroidism. An easily treatable condition. As for our culture's current ailment, the remedy will be forever evasive unless our leaders are willing to call a spade a spade -- and apply the remedy to the cause. And for what it's worth, it's not redheaded Irishmen wielding the guns.
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